What’s new in D.C.?

December 14, 2011

Recently the Obesity Action Coalition (OAC), a non- profit organization with more than 33,000 members formed to represent people affected by obesity and the American Society of Metabolic and Bariatric Surgery (ASMBS) made multiple visits with several government and regulatory agencies on behalf of the obese patient and bariatric surgical insurance benefits.

 

The future of obesity treatments in light of healthcare reform is an unknown. Inclusion or exclusion in the proposed Essential Healthcare Benefits Package (EHBP) will either be an opportunity for access to care or a threat of non-access.

 

Currently, several possible scenarios exist in regard to the EHBP:

1. Bariatric surgery as a Standard Benefit:

Every American covered by heath insurance would automatically have the benefit for bariatric surgery.

 

2. Bariatric surgery is excluded as a Standard Benefit:

This is a worst-case scenario and coverage would be excluded as a standard benefit for every American covered by heath insurance.

 

3. Not specified as Included or Excluded:

This would mean that groups like the OAC, ASMBS, and commercial manufacturers would have to lobby state to state for state legislation as a standard benefit, much as it is today.

Other organizations included in this fight include: The Obesity Care Continuum (OCC), an organization of healthcare professionals. The OCC is a coalition of the OAC, the Obesity Society (TOS), the American Dietetic Association (ADA) and the ASMBS.

 

On the commercial side, Allergan, the manufacturer of the LAP-BAND, has formed the Allergan C.H.O.I.C.E. (Choosing Health over Obesity Inspiring Change) Campaign. Their purpose is to bring together consumers, healthcare professionals and Congress to work together in providing a dual approach through prevention and treatment.

One of the key components of the efforts in Washington is the education of Congress through in-person visits and legislative briefings. Recently, legislative briefings featured Dr. Christopher Still and Dr. Scott Kahan. Members of Congress supported inclusion, and in the Senate, more than 50 members signed a letter urging the Secretary of the Department of Health and Human Services (DHHS) to support inclusion.

 

Additionally, the OAC, ASMBS, and their partners are  focused on bringing other medical organizations into the fold to assist with support of their efforts. Fourteen organizations have sent letters to the Secretary of HHS.

 

Draft legislation regarding Essential Healthcare Benefits are expected in Spring 2012.

Stay tuned for updates on this important legislative issue.

Lap-Band FAQs

December 13, 2011

What age do I have to be to have LAP-BAND® Surgery?

The LAP-BAND procedure is indicated for individuals who are over the age of 18.

 

What weight do I have to be to have LAP-BAND® Surgery?

Typical inclusion criteria are:

BMI of 40: or greater

BMI of 35 to 40: At least one comorbidity such as diabetes, cardiovascular disease, hypertension. Your Health Insurance Plan will have these listed in you benefits booklet.

BMI of 30 to 35: New LAP-BAND® surgery guidelines have been issued by the Food and Drug Administration. After reviewing studies on the results of LAP-BAND® surgery, the FDA has lowered the minimum body mass index to be eligible if patients have an obesity-related condition. The new FDA guidelines make about 26 million more obese Americans eligible for LAP-BAND® surgery.

We can help you check with your Health Plan to see if you can take advantage of the new FDA guidelines or help you secure financing.

You can calculate your BMI (Body Mass Index) here:

http://www.nhlbisupport.com/bmi/

 

How does the LAP-BAND® work ?

LAP-BAND® Surgery helps with weight loss by restricting the amount of food you can eat. The procedure decreases food intake by creating a small upper stomach pouch that only allows a small amount of food to enter. Digestion is also be slowed, which helps you feel full longer.

 

How fast will I lose weight with LAP-BAND® Surgery?

Your rate of weight loss will be largely dependent on your compliance with the LAP-BAND® guidelines and will vary from person to person. It is important to eat only three small healthy meals a day, no snacking between meals, drink only low-calorie beverages and exercise 30 minutes a day. Your results may vary, but on average, a LAP-BAND® patient loses about 2 pounds per week and about 50% of his or her excess weight within the first year of surgery. So for example, if you are 100 pounds overweight then you will lose 50 pounds (50% of 100). Men tend to lose weight faster than females.

 

Will I be able to eat regular food after LAP-BAND® Surgery?           

After the recovery period you will be slowly introduced to regular food. You will need to make healthy choices by eating a well-balanced diet. Avoid high-fat and high-calorie foods. There will also be some foods you will want to avoid because they tend to cause problems with the LAP-BAND®. For some patients, avoid foods such as fibrous foods, bread, pasta, dried fruit, nuts, coconut, popcorn, and fried foods. You will learn what you can and can’t eat.

 

What are the advantages of LAP-BAND® Surgery?

With LAP-BAND® Surgery, there is no stomach cutting or intestinal rerouting. It is reversible, adjustable, and less invasive than the Gastric Bypass or Sleeve. Recovery time is typically quicker and we do all of our procedures at an oBand Ambulatory Surgery Center to keep you out of the hospital. Also there is a lower chance of nutritional deficiencies with the LAP-BAND®. The procedure also has the lowest complication rate and lowest mortality rate of all weight loss surgeries.

Lap-Band Diet – Now What?

December 5, 2011

OK, so now you have progressed from your post-op diet to eating normal foods again. Now what? You will be able to enjoy most foods that you enjoyed in the past just in much smaller quantities. You will be chewing more and eating more slowly. There may be some food that you cannot tolerate, this is different for everyone, so please consult with the experts at your oBand Surgery Center or Clinic.

The Lap-Band will help control how much food you can eat, but it will be totally up to you to make healthy food choices. The Gastric Band works best when you eat solid foods. Solid foods decrease hunger because they stay in the stomach pouch longer. You should feel full after eating only a few ounces of solid food.

Your diet should include foods that are high in protein, low in fat, and high in nutritional value such as skinless poultry, tender meats, fish, and eggs. You should eat your protein source first to assure you are getting enough. You should be eating plenty of fruits and vegetables, avoiding fibrous foods such as asparagus, celery, corn, dried fruit, oranges, pineapples, sweet potatoes and stringy or tough meats. Tolerability to certain foods will vary patient to patient. You should also include low or non-fat dairy in your diet, avoiding whole milk products.

You should be eating three high-quality meals a day and avoid snacking in between meals. You will learn to push your plate away when you are full. You do not have to clear your plate. Try to avoid consuming fluids during meals. Fluids during a meal will quickly wash your food down and you will not experience the feeling of fullness from your food. Throughout the day, be sure and stay well-hydrated. Avoid high calorie liquids such as milkshakes, juices, soda, and whole milk. You may want use low calorie water additives such as Crystal Lite to assure adequate fluid intake. Carbonated drinks like as soda, champagne, and beer can increase the size of the pouch and cause discomfort. Alcohol in excess is not recommended because it is high in calories, has no nutritional value, and the excess calories will slow your rate of weight loss. An occasional, small amount of wine or other alcoholic beverage may be tolerated; everything in moderation.

Your Lap-Band is a tool to help you succeed in your weight loss journey. The team at your local oBand Surgery Center will teach you how to use your tool effectively and give you specific instructions regarding your diet. You should see your surgeon as advised and re-schedule any appointments that you may miss. We are here for you as partners in your journey if you are ever in doubt about your diet or your progress. Also both the Allergan Lap-Band and the Ethicon REALIZE Band have online tools to help you chart your progress. Allergan even has a mobile app to assist you.

oBand Surgery Centers and Your Insurance

At oBand® Surgery Centers and Clinics we accept most major Health Insurance Plans. First and foremost you must review you policy to determine if you have the “Benefit” to have weight loss surgery through your Health Insurance. Not all Health Plans cover Bariatric Surgery.  This is totally dependent on your employer and whether or not they have purchased the “Benefit” for you.

For instance, your Health Insurance may be through Aetna and your cousin may also have Aetna. You both work for different employers. One of you may have coverage and one may not. Again, it is up to your employer, not the insurance company.

The oBand® team of experts can help you determine whether you have an exclusion or the benefit (inclusion) for bariatric surgery. In the event coverage is not offered, oBand® will continue to present your case if you are a candidate with extenuating circumstances. oBand® will initiate an appeals process with your health insurance on your behalf. We can also assist you with financing.

Some of the Health Plans that we accept include: Blue Cross of California, Blue Shield of California, Blue Cross Blue Shield of Nevada, Blue Cross Blue Shield of Florida and the majority of “Out of State” Blue Cross Blue Shield Plans.

The National Plans that we accept include: Aetna, Cigna, United Health Care, Mailhandlers, GEHA (Government Employees Health Association), Federal Plan Blue Cross Blue Shield, Beech Street, Tri-Care, ILWU (International Longshore and Warehouse Union) and Union Pacific. This is only a partial list. Our administrative team will happily assist you with your insurance.

We are not providers for Medicare, MediCal or any Medicaid programs in the States of Florida or Nevada.

Generally to qualify for Lap-Band or REALIZE Band surgery you must meet the following criteria:

  1. Be 18 years of age
  2. Have a BMI (Body Mass Index) of > 40

Or Have a BMI between 35 and 40 and have one or more co-morbidities such as Type II Diabetes, Hypertension, and Sleep Apnea.

Please be aware that these are only general guidelines and a partial list of co-morbidities. Certain Insurance Plans may also cover adolescents.

Specific requirements will be outlined in you Health Insurance Benefit booklet available from your Employer’s Human Resources Department.

Also there may be requirements for a pre-operative diet, documentation of past weight loss attempts, a referral by a primary care doctor, an evaluation by a mental health professional and/or a nutritional specialist. Experts at oBand® Surgery Centers will assist you with all of your requirements and expedite the road to a healthier you.

9. I’m Allergic to Latex, I can’t get a Band

The Lap-Band is made of medical grade silicone, not latex. Silicone is considered hypoallergenic. Silicone is an inert substance typically used in latex-allergic patients. It is the same substance used in many other medical implants. It is not recognized by the body and therefore not susceptible to reactions.


10. I will never be able to go out to dinner again and enjoy food

One of the main objectives of Lap-Band weight loss surgery is to be able to have a normal relationship with food. You will be able to enjoy most foods that you enjoyed in the past, just in much smaller quantities. You will learn to push your plate away when you are full.

There may be some food that you cannot tolerate, but this is different for everyone.

The team at your local oBand Surgery Center will train you to use your new tool and still enjoy dining out. Since you will be eating more slowly, you will be able to have a more enjoyable dining experience.


11. The Procedure is too Risky

The oBand Surgeons who perform the Lap-Band procedure are highly trained laparoscopic surgeons. They meet rigid standards for qualification. They are also trained by both Allergan and Ethicon the manufacturers of the Lap-Band and REALIZE Band.

The Lap-Band is less invasive, has fewer risks and a faster recovery time than the Gastric Bypass or the Gastric Sleeve. There is no cutting, stapling or rearrangement of the anatomy with the Lap-Band. The Lap-Band has been shown to be 10 times safer than the Bypass.

While the Gastric Banding is less invasive than other surgical weight loss procedures, all surgical procedures have risks. It is important to know what the risks are by talking with your oBand Surgeon about any concerns you may have.


12. I will have to be on a Liquid Diet Forever

You will be on a liquid diet following your surgery and sometimes after you have had an adjustment. Your oBand Surgeon will advise you on the duration of any liquid diet that may be prescribed. A liquid diet post-op involves giving the stomach a rest after surgery. Ingesting liquids only during this phase helps with the healing process by lessening stomach contractions since you are not moving solid food through the digestive tract. You will slowly progress to solid foods as instructed by your oBand Doctor.

Once you have progressed to solid food you should only use low calorie liquids and stay well hydrated. Liquid diets are not advisable. You will not feel satisfied with liquid diets as you would with solid food. The whole point of Lap-Band surgery is to be able to eat normal food just less.


13. I won’t be able to have Children in the Future

Morbidly obese women of childbearing years may also experience fertility problems due to their weight. Higher amounts of fat tissue may throw your fertility hormones out of balance and make it harder to get pregnant. Losing the weight through Bariatric Surgery may increase your chances of getting pregnant.

Typically should you become pregnant fluid will be removed from your Band for the duration of your pregnancy. If you have concerns in this area they should be discussed with you surgeon at your local oBand Surgery Center.

5. Lap Band Surgery is Cosmetic Surgery

No, Lap-Band surgery is considered bariatric or weight loss surgery and is performed on morbidly obese individuals.  A person who is morbidly obese is at serious health risk because of the strain the extra weight places on the body and the other risks associated such as asthma, hypertension, depression, diabetes, cardio-vascular disease and infertility.  Some of conditions can be life threatening. Weight loss surgery can either completely resolve them or at the very least improve them.

Lap-Band surgery is performed at oBand Surgery Centers by our highly trained Bariatric Surgeons.

 

6. Lap-Band Surgery will Solve all My Over-eating Problems

The Lap-Band is not a “Magic Bullet.”  It is “Tool,” which when used properly will assist you to take control of your eating habits.  We will teach you how to use your new “Tool” to ensure you get the best results.  It is necessary to chew every mouthful slowly and well.  It will take a considerable amount of time to work your way through much less food. You will be eating slowly. You will be getting the emotional and psychological support to enable your Lap-Band to be effective.

7. Now I’ve Lost my Weight I can have the Lap-Band Removed

The Lap-Band is a lifetime commitment and the device meant to stay in forever. The band is a tool to assist you with overeating.  Therefore, if you have the band removed, just like when you have the fluid removed from the band, there will be nothing physical to restrict your eating. Removal of your Lap-Band will lead to rapid regaining of the weight lost and then some.

8. The Lap-Band Works the Same Way for Everyone

No, not really. We are all individuals and your experience will be unique.  What works for one patient will not necessarily work for another and what causes problems or issues for one banded person will not always cause problems for another. Typically men will loose weight faster than women.

The worst thing you can do to yourself is to compare your results to your Banded friends or in a support group. Results will vary, but if you stick to the plan laid out for you by oBand Centers you will achieve success.

1. I will not loose as much weight as a Gastric Bypass Patient if I get the Lap-Band.

Gastric Bypass patients will initially loose their excess weight more rapidly. Lap-Band patients will loose on average 1-2 pounds per week. We consider this slower weight loss a healthier approach with minimal nutritional complications. Also issues with excess skin may also be less with slower weight loss.

Recent studies by Dr. Paul O’Brien, M.D. a world-renown Lap-Band expert show that Lap-Band patients experienced weight loss that actually exceeded amounts lost by gastric bypass patients after a period of five years.

Remember it’s not a race, it’s a journey.

 

2. Lap-Band surgery is not for “Sweet Eaters”

It is commonly believed that sweet eaters are not good candidates for Lap-Band weight loss surgery though there is actually little evidence for this. Dr. Paul O’Brien studied 200 patients to see if this was true. Patients who had their bands for a year were asked to fill out a questionnaire regarding their sweet eating behavior. Results showed almost identical weight loss in the sweet eaters vs. the non-sweet eaters.

At oBand, you will get the proper nutritional guidance to optimize your success.

 

3. Lap-Band surgery will not resolve obesity-related health conditions.

Lap-Band has been shown to improve asthma conditions in 60% of patients, 65% of patients with diabetes have seen resolution of their condition after Lap-Band surgery, while 95% of patients successfully resolved their sleep apnea.

 

4. Lap-Band adjustments hurt

The needle used to adjust your band is extremely fine. Also, we will numb the area to help make your discomfort minimal.

Our Doctors:

Choosing the right bariatric surgeon is a difficult decision, but it doesn’t have to be. Asking the right questions and knowing what to look for in a bariatric surgeon can make this task less daunting. It is important that the patient, their friends and family have complete confidence in the doctor performing the surgery. oBand® understands this requirement. All of our surgeons must be credentialed by oBand®, meet or exceed the requirements of the American College of Surgeons (ACS) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Board certification by the American College of Surgeons indicates that the bariatric surgeon has completed a training program and met certain predefined standards. Our Bariatric Surgeons are also members of the ASMBS, American Society for Metabolic and Bariatric Surgery, the professional society for Bariatric Surgeons and Health Professionals.

When it comes to a bariatric surgeon’s experience, the number of procedures matters. Many studies have shown that complication rates from weight loss surgery depend highly on how many procedures the surgeon has completed. Consider this factor when choosing a surgeon. oBand® doctors have performed thousands of procedures.

You must have a good rapport with your bariatric surgeon. He or she should be patient and willing to spend time describing your procedure, discussing any concerns or questions that you may have. Also, aftercare following your surgery will be a key element to your success.

 

Our Facilities and Staff:

As a leading provider of Lap-Band surgery oBand® Surgery Centers have been granted “Full Approval” and are officially recognized as an American College of Surgeons Level Outpatient Accredited Bariatric Center (ACS BSCN). Our staff and outpatient surgery centers have been recognized for providing high quality care to our patients undergoing bariatric surgery.

 

Weight loss surgery can be costly and the insurance system is difficult to navigate. Our staff of experts is ready to assist you with all of your insurance needs or to help you obtain financing.

 

The actual weight loss surgery is just the first part of your journey. Follow-up care is an important part of the equation. The center you choose should offer such services as support groups, psychological support, nutritional counseling and access to your surgeon. The counseling and support will be provided to help your transition from old habits to a set of new lifestyle changes.

 

Our team of experts at oBand Surgery Centers will do our best to try and obtain coverage for your weight loss surgery through your insurance; unfortunately it is not always possible. If insurance is not an option, oBand® has financing options available for you to choose from.

The return on your investment to change your life forever through surgery at oBand may be realized in a few short years by potential tax savings, personal life-style savings and healthcare savings.

 

Tax Savings

You may realize potential tax savings in the year you finance or pay cash for your Lap-Band®. You may be eligible to receive thousands of dollars back depending on your adjusted gross income. IRS Publication 502 states you can deduct your medical and dental expenses when they total more than 7.5% of your Adjusted Gross Income.

For more information, see the IRS publication: http://www.irs.gov/publications/p502/index.html

Tax and financial circumstances are different for each person and the tax laws are constantly changing.  This information should not be considered financial advice.

You should seek financial advice from a professional for any questions you may have.

 

Personal and Healthcare Costs

Are you on any medications for obesity related illnesses?

Have you ever missed work because of your health?

Do you spend money on weight loss programs like, Weight Watchers, Jenny Craig or other special diets?

Also by eating less, you spend less on groceries and eating out.

 

According to the June 2005 online version of the Journal Health Affairs, the cost of obesity can add up to $15,568 a year, including medications and food.

 

WEIGHT-RELATED COSTS

 

This includes:

Medical/Drug costs                                                               $5,965

Out of Pocket Healthcare Expenses                                  $2,182

Employment Inactivity Costs                                              $900

Commercial Weight loss Programs                                  $600

Prescription Co-Pays                                                            $600

Grocery and Dining Costs                                                   $5,321

Total                                                                                          $15,568

 

If you add up all the costs related to being overweight, you may think that you can’t afford not to have something done.

Understanding Your Insurance

November 15, 2011

If you suffer from morbid obesity and you are contemplating bariatric surgery dealing with and understanding your health insurance may be a daunting task. The oBand® team of experts is here to help you with this process.

 

There are two ways you could be covered for medical insurance:

Fully insured policy- Insurance that you pay for yourself, or that is paid in full or in part by your employer. If the employer plan is fully insured, the insurance company is ultimately responsible for the healthcare costs, and your employer (or your spouse’s employer) typically purchases a standardized package of coverage. You may or may not have the benefit for bariatric surgery.

Self-insured policy - You may be covered by an employer’s self-insured medical benefits plan. With a self-insured plan your employer (or your spouses employer) is ultimately responsible for the healthcare costs. The insurance company is only the administrator of the plan. As with the fully insured policy the decision to have a benefit for bariatric surgery is fully up to your employer.

 

In either case (fully insured or self-insured) you should get a copy of your health insurance policy. Ask your human resources department at work or your insurance company for this. Often times this document can be downloaded from the Internet on a site that is specific to your employer.

 

You must review your policy to determine if you have an exclusion or inclusion for weight loss surgery. Exclusions are medical services not covered by an individual’s insurance policy. If your policy has an inclusion, this means that your policy covers bariatric surgery, under certain conditions and you will be required to meet certain criteria. The oBand® team of experts can help you determine whether you have an exclusion or the benefit (inclusion) for bariatric surgery. Unfortunately, not every insurance plan will cover bariatric surgery. In the event coverage is not offered, oBand® will continue to present your case if you are a candidate with extenuating circumstances. oBand® also has the ability to initiate an appeals process on your behalf.

 

Once we have helped you have determine the type of coverage you have we will assist you in getting pre-approved for your procedure. Pre-approval is required for weight-loss surgery.

 

It is advisable to keep good health records, this will make the process of getting you approved less complex. You should keep track of things like visits with your primary care doctor (including dates and any records documenting your height and weight), documentation of prior attempts to loose weight, health problems related to your obesity (such as diabetes, infertility, heart disease, etc.) and medications that you may be taking. Our expertise in submitting prior request authorization packages allows us to get you processed in a timely and efficient manner.

 

If insurance is not an option, oBand® has financing options available for you to choose from. Please contact us to explore your options.

 

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